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DUAL DIAGNOSIS: Eating Disorders & Addiction

People with a dual diagnosis for both Substance Use Disorder (SUD) and an Eating Disorder face unique challenges when seeking treatment.  With the right combination of integrated treatment for both co-occurring disorders, recovery is possible. 
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Eating Disorders and Addictions

Compulsive thoughts. Secretive behaviors. A decline in physical health. 

If you’re experiencing any of these symptoms, you could be struggling with any number of behavioral health issues. You may be living with an eating disorder or struggling with addiction and substance abuse. Believe it or not, both eating disorders and addiction have a lot in common, including how they make you feel. 

Both addiction and eating disorders share similar causes. As a result, they often occur together, leading to a dual diagnosis. Luckily for those who are struggling, treatment is available for both.

Defining Eating Disorders

It can be hard to define eating disorders because they present in many different ways. Individuals with the same diagnosis may have completely different patterns of disordered behavior. All eating disorders have factors in common which provide a general guideline. 

Individuals with eating disorders experience thoughts and emotions of a distressing nature surrounding the topic of food. These thought patterns can lead to changes in behavior related to food and exercise. The combination of thoughts and behavior lead to problems with social, psychological, and even physical functioning. 

Many people assume that all eating disorders look like anorexia, but that is not the case. The media has romanticized anorexia nervosa and other restrictive disorders, so they tend to appear in the media. Restriction is only one form of disordered behavior surrounding food.

Eating disorders typically begin in adolescence and young adulthood and are most commonly diagnosed in females. Even so, disordered eating can affect individuals of any age or gender expression and can begin at any time. 

It is not uncommon for eating disorders to co-occur with other behavioral health diagnoses. These include anxiety disorders and obsessive-compulsive disorders. Eating disorders also regularly co-occur with substance abuse, and this article will further discuss why that is the case. 

Types of Eating Disorders

Because the definition of eating disorders is so broad, they are often broken down into subcategories. Each subcategory is a diagnosis. These diagnoses are not static and can change when patterns of behaviors shift. 

Anorexia Nervosa

Individuals with anorexia nervosa focus on weight loss and smaller body sizes. Individuals with the disorder diet incessantly due to a fear or phobia of gaining weight. They often have a low BMI, making anorexia the eating disorder with the highest mortality rate.

The two subtypes of anorexia nervosa include the restricting type and the binge/purge type. Individuals with restricting type lose weight through dieting, fasting, or exercising. Individuals with the binge/purge type engage in binging and purging behaviors.

Bulimia Nervosa

Individuals with bulimia nervosa tend to have cycling behavior. They switch between restrictive behaviors and binge eating.

Binging behavior is traditionally accompanied by compensatory behaviors. These include purging, fasting, excessive exercise, or the use of laxatives.

Individuals with bulimia nervosa are not associated with any particular BMI. Many are average or overweight. It is the behavior and preoccupation with food that leads to the diagnosis. 

Binge Eating Disorder (BED)

Individuals with Binge Eating Disorder engage in binging behavior characterized by a loss of control. They may consume food in extremely high quantities, often past the point of fullness. The behavior is often secretive and leads to a feeling of deep shame and distress in the aftermath.

Individuals with BED do not engage in compensatory behaviors. Binge Eating Disorder is also not associated with a specific BMI range. Individuals with the condition are often overweight.

Other Specified Feeding and Eating Disorder

Other Specified Feeding and Eating Disorder (OSFED) describes individuals who do not meet the diagnostic criteria of other eating disorders. These individuals may engage in behaviors common in anorexia or bulimia, but less frequently. 

Avoidant Restrictive Food Intake Disorder (ARFID)

Individuals with ARFID look a lot like extremely picky eaters. Their behavior may be restrictive but not involved a preoccupation with weight loss. Often, the behavior is driven by anxiety or phobias. 

For example, an individual with ARFID might have an irrational fear of a specific food causing an allergic reaction. Certain sensory characteristics of food may repulse them. They may also simply have a low appetite or lack interest in food for other psychological reasons.

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Defining Addiction

You may not have considered it in the past, but eating disorders and addiction have a lot in common. Like eating disorders, addiction looks different for every individual. They are both characterized by compulsive behaviors with harmful consequences.

Individuals suffering from addiction become preoccupied with substances. This is not unlike the way that individuals with eating disorders become preoccupied with food. This preoccupation leads to impairment and an inability to function properly in day-to-day life. 

We characterize addiction using four factors:

It is common for an individual living with addiction to also struggle with an eating disorder. In fact, an eating disorder is sometimes considered an addiction to a pattern of behavior. 

Is an Eating Disorder an Addiction?

Some people believe that an eating disorder is a form of addiction. Others disagree. It’s important to look at the causes of eating disorders and addictive behaviors to see what they have in common. 

Shared Causes

Eating disorders and addiction have four shared causes. They are genetics, environment, trauma, and mental illness. 

Foremost, many addictions and eating disorders have a genetic root. 60% of eating disorders and addictions are found in families. Many neurotransmitters responsible for disordered and addictive behavior are also shared. 

The environment can lead to both addiction and disordered eating because of social norms. Many individuals begin their behaviors due to diet culture, peer pressure, or family pressure. 

Underlying trauma or emotional pain are common triggers for EDs and addiction. Often, the behavior is a response to subconscious struggles and a need for control. Furthermore, untreated mental illnesses may have the same effect.

Self-Medication

Our bodies are designed to eat, and it’s our job to nourish them. That makes life with an eating disorder challenging. Your body and culture are always fighting against you, and it’s common to feel like you are failing.

As a result, many individuals with eating disorders turn to substances to self-medicate. Sometimes turn to drugs because they suppress appetite, making it easier to engage in restriction. 

Likewise, disordered eating can help individuals with substance abuse issues regain some control. The ability to purge is valuable to those who drink excessively. Others use alcohol to deal with anxiety surrounding eating. 

It’s easy to believe that disordered behavior or the use of substances are “tools” rather than problems. They are both ways to gain control. When restriction or binge drinking becomes easy, they quickly become dangerous.

Both eating disorders and substance abuse are distressing. That’s why it’s common to use one to soothe the other. From there, it’s easy to get stuck in a loop.

In this way, substance abuse can make your eating disorder worse. Individuals with a dual diagnosis are at a higher risk of fatality than individuals with only one diagnosis. 

Eating Disorder Treatment and Addiction Treatment

Eating disorders and addiction have many of the same root causes. That means they are often diagnosed together. Luckily, you can treat both at the same time, too.

Dual diagnosis treatment programs have been proven effective at providing support for individuals with addictions and eating disorders.

In treatment, you may be prescribed medications that can help you eliminate the underlying causes of both EDs and addiction. You will attend individual and group therapy, where you will learn healthy coping strategies. You will be able to address the root cause of both issues and find relief. 

Addiction and eating disorders are mentally and physically taxing. Because of that stress, a residential treatment program is ideal. You will be surrounded by medical and psychological professionals with the skills and experience to create a treatment plan for you.

In treatment, you will learn how to live a healthy, sober life surrounded by a community of individuals who understand. 

If you are struggling, now is the time to seek help for your addiction and your eating disorder. Treatment can ensure a long, happy life free from distressing thoughts and compulsive behaviors. 

Why We're One Best Dual Diagnosis Treatment Centers

New Method Wellness has everything you need to relax and focus on your behavioral health, from lovely accommodations to innovative therapies. Contact New Method Wellness to begin the process of reclaiming your agency. Your healing journey might become the next success story. 

Handpicked by Dr. Phil, New Method Wellness is a premier dual diagnosis addiction treatment center dually accredited by The Joint Commission. It has been singled out as one of the best drug and alcohol rehab centers in America, offering a unique 3:1 staff-to-client ratio that pairs every client with two therapists instead of one.

At New Method Wellness, we add another dimension to dual diagnosis treatment, and that is the integration of holistic therapy, such as massage/acupuncture therapy, equine therapy, and art therapy. As addiction therapists and substance abuse counselors work with clients to treat the substance use disorder and the co-occurring illness associated with it, holistic therapy adds meaning to life after treatment and sustains long-term recovery. Our 3:1 staff-to-client ratio ensures client success after treatment, as evidenced by our Extended Aftercare program.

For more information about New Method Wellness’s treatment programs, call 866-951-1824

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Clinically Reviewed By:

Deanna J. Crosby, M.A., LMFT, LAADC, Psy.D. (C)

Deanna Crosby is a Licensed Marriage and Family Therapist (LMFT) with over 20 years of experience working with clients in recovery. Her expertise has catapulted her into the spotlight. Featured on several episodes of the Dr. Phil Show as a behavioral health expert, DeAnna is a routine contributor for NBC News, The Huffington Post, Elle Magazine, MSN, Fox News, Yahoo, Glamour, Today, and several other prominent media outlets. 

After receiving her bachelor’s degree from the University of California in Irvine, Crosby did postgraduate work at Centaur University where she graduated at the top of her class with a CAADAC certification in Centaur’s chemical dependency program. Following her time at Centaur, Crosby received her Master of Counseling Psychology degree from Pacifica Graduate Institute, where she also attained a Doctoral Degree in Depth Psychology.

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From all of us at New Method Wellness co-occurring treatment center, we wish you peace and serenity in knowing that you or your loved one will get the necessary help.

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